Question 1

What is HCPCS code M1033?

Accepted Answer

HCPCS code M1033 is "Pharmthry for oud afr 6.30". Pharmacotherapy for oud initiated after june 30th of performance period

Question 2

What category is M1033 in?

Accepted Answer

M1033 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M1033?

Accepted Answer

Use M1033 when billing for pharmthry for oud afr 6.30. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is M1033 covered by Medicare?

Accepted Answer

Coverage for M1033 (Pharmthry for oud afr 6.30) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for M1033?

Accepted Answer

Documentation for M1033 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).